Final Entry: November 16, 2008
Upon finishing the unit, I am very happy that it is over, because it was incredibly tiring, but I also am very grateful for the whole experience. Firstly looking back on it, I didn’t realise how tiring the process would be. I expected to leave the hospital each day and have the remainder of the day left to do things, but put simply, I didn’t because most days I would leave completely exhausted. I also feel I received a lot more ‘hands-on’ experience than I was expecting and because I was doing these hands-on activities with the patients from day 1, I got to see many things, but because I also got to perform them many times I also got experienced and fairly skilled at performing some of these tasks.
From participating in the unit, I definitely learnt the importance of treating the patient as a person or a whole and not just as an injury or a case. I learnt the importance of documentation, where if you record things well, then you know exactly what you have done if you are to look back on it in the future. Also in working with a multi-disciplinary team where the patient may tell different members of the team different pieces of information, it becomes important to document the information that has been provided to you. I’ve also learnt the importance of improvisation. Working in amputees, which is a very specialised department, there is a lot of specialised equipment for these people, but if you do not have the resources at your disposal, then it is important to get imaginative and creative with exercises and also with the equipment that you do have. For example, if working in a remote environment, you aren’t going to have the same equipment as the rehab hospital does, but for the sake of the patient, you are just going to have to make the best effort with the resources that you do have. I also learnt lots about diabetes – I never realised just how serious diabetes was before participating in this unit.
I really enjoyed this placement, I did have a few incidents along the way, but I guess that’s to be expected in a profession where there are so many different opinions flying around the place. However, I learnt so many things, saw some incredible things and met a lot of amazing people too! This was a great experience for me, but after 5 weeks, I am glad it’s over!
Ozzman out!
Saturday, November 15, 2008
Week 5: November 16, 2008
The other day I had one of the amputee in-patients doing some unassisted walking in the parallel bars. This patient had bilateral below knee amputations, so was walking with 2 lower limb prostheses. I had the patient walking without walking aids, however I was right next to her with one hand in front, one behind and because she was only a slight build, I felt comfortable that I could control her if anything did happen.
The patient would usually take around 6-8 steps before beginning to wobble a bit and I would stabilize her, but then she managed to travel the entire length of the bars, which would have been in excess of 25 steps. After congratulating her, I said that she should have a rest in her wheelchair and then we would do some more. Just as the patient was exiting the parallel bars, she lost her footing and began to fall. Miraculously(!) I reached over the bars, got one arm behind her back and also managed to grab her forearm (the patient also had hand and wrist amputations) and caught her inches above the ground. I got her back upright and we made it to the chair.
This was the first time a patient had begun to fall on me and my heart was pounding at a squillion miles per hour. My supervisor had told us that people can fall and be on the ground in a split second and after this little incident, I can safely say that, YES, it happens in a split second! But what I learnt from all this was that, you can never be too careful when you have a patient in your care. In my case, the patient had just walked over 25 steps without an aid, and then almost fell after 2 or 3 steps while walking with the support of the bars, so it can be hard to tell when there is a potential accident just around the corner. So yeah, it’s better to be safe than sorry!
Ozzman out!
The other day I had one of the amputee in-patients doing some unassisted walking in the parallel bars. This patient had bilateral below knee amputations, so was walking with 2 lower limb prostheses. I had the patient walking without walking aids, however I was right next to her with one hand in front, one behind and because she was only a slight build, I felt comfortable that I could control her if anything did happen.
The patient would usually take around 6-8 steps before beginning to wobble a bit and I would stabilize her, but then she managed to travel the entire length of the bars, which would have been in excess of 25 steps. After congratulating her, I said that she should have a rest in her wheelchair and then we would do some more. Just as the patient was exiting the parallel bars, she lost her footing and began to fall. Miraculously(!) I reached over the bars, got one arm behind her back and also managed to grab her forearm (the patient also had hand and wrist amputations) and caught her inches above the ground. I got her back upright and we made it to the chair.
This was the first time a patient had begun to fall on me and my heart was pounding at a squillion miles per hour. My supervisor had told us that people can fall and be on the ground in a split second and after this little incident, I can safely say that, YES, it happens in a split second! But what I learnt from all this was that, you can never be too careful when you have a patient in your care. In my case, the patient had just walked over 25 steps without an aid, and then almost fell after 2 or 3 steps while walking with the support of the bars, so it can be hard to tell when there is a potential accident just around the corner. So yeah, it’s better to be safe than sorry!
Ozzman out!
Monday, November 10, 2008
Week 5: November 10. 2008
Today was an interesting day, although nothing really out of the ordinary happened. I spent the morning at Royal Perth’s Wellington Street campus, where I got to see some amputees in their acute care and rehabilitation setting on a number of the wards there. There was one incident, that didn’t seem important to me at the time, but when I thought about it on the train ride back to Shenton Park, it became a bit more significant to me.
I was with one of the senior amputee physios from Shents while I was going around the wards and when we were checking the status of one patient, we spoke with one of the physios there. The physio told us that she had done only a very limited amount with the patient because the patient was new, but she also explained that she had not worked with amputees before and had a few questions to ask. As she was asking the questions, I was surprised to learn that I could answer most of them! They were mainly positioning and mobility/related questions, with a few others chucked in there and they were things that I find myself doing without thinking now, after 4 and a bit weeks of amputees, but there is no way I would have known before I started.
I guess what I’m saying, in a round-about way, is that it showed me the power of asking questions if you are unsure about something. Also that, if you are unsure, it never hurts to ask around for help, because you never know who might have the answer to your question. And at the end of the day, the important thing isn’t who helped, or how, rather it’s that the person in your care receives the treatment that will enable them to make the best quality recovery possible.
Ozzman out!
Today was an interesting day, although nothing really out of the ordinary happened. I spent the morning at Royal Perth’s Wellington Street campus, where I got to see some amputees in their acute care and rehabilitation setting on a number of the wards there. There was one incident, that didn’t seem important to me at the time, but when I thought about it on the train ride back to Shenton Park, it became a bit more significant to me.
I was with one of the senior amputee physios from Shents while I was going around the wards and when we were checking the status of one patient, we spoke with one of the physios there. The physio told us that she had done only a very limited amount with the patient because the patient was new, but she also explained that she had not worked with amputees before and had a few questions to ask. As she was asking the questions, I was surprised to learn that I could answer most of them! They were mainly positioning and mobility/related questions, with a few others chucked in there and they were things that I find myself doing without thinking now, after 4 and a bit weeks of amputees, but there is no way I would have known before I started.
I guess what I’m saying, in a round-about way, is that it showed me the power of asking questions if you are unsure about something. Also that, if you are unsure, it never hurts to ask around for help, because you never know who might have the answer to your question. And at the end of the day, the important thing isn’t who helped, or how, rather it’s that the person in your care receives the treatment that will enable them to make the best quality recovery possible.
Ozzman out!
Saturday, November 8, 2008
Week 4: November 8, 2008
One of the amputees that I have been working almost exclusively with is an elderly gentleman who is an outpatient with a below knee amputation. He comes 3 times a week, each for around 2 hours. Over the past few weeks I have drifted towards him because he is a very interesting character, but also because without guidance, he would choose not to do a whole lot of work when he comes to the gym!
From working closely with this gentleman, I feel we have developed quite a close patient-therapist relationship. Because of this, I believe we have been achieving a fair bit and it feels great to know that I am actually helping someone. However, problems with the patient’s prosthesis fit have been causing considerable pain of late, which has unfortunately been limiting our progress.
Because of these problems, the patient was booked into the weekly amputee clinic/check-up for outpatients. On this day, I got called into the clinic, because I had been requested by the patient. After a chat with the patient, doctor and the prosthetist, where I basically informed them of the what had been happening over the past few weeks, the problems that we were having and what I thought was going on, a new plan was decided upon. Originally, the patient was going to get a whole new leg, but from the information that I provided, which the patient either didn’t tell or simply forgot, the prosthetist ended up just adding some extra padding to the back of the prosthesis. And judging of the vastly improved performance the following day in the gym, it worked! WOOP!
So, yeh, that was pretty rewarding for me! But to sum things up, I learnt some of the benefits of working closely with a patient, and especially those associated with a rehabilitation setting, where, by essentially being the sole therapist with the patient, I had the knowledge on what progress was/wasn’t being made. Obviously it’s not always advisable to have just the one therapist working on a case, for example it’s good to have opinions and suggestions from multiple directions, but by having someone there for most, if not all the time, they will be in a good position to decide what the next step should be, in order to maximise recovery.
All is good! Only 1 week to go!!!
Ozzman out!
One of the amputees that I have been working almost exclusively with is an elderly gentleman who is an outpatient with a below knee amputation. He comes 3 times a week, each for around 2 hours. Over the past few weeks I have drifted towards him because he is a very interesting character, but also because without guidance, he would choose not to do a whole lot of work when he comes to the gym!
From working closely with this gentleman, I feel we have developed quite a close patient-therapist relationship. Because of this, I believe we have been achieving a fair bit and it feels great to know that I am actually helping someone. However, problems with the patient’s prosthesis fit have been causing considerable pain of late, which has unfortunately been limiting our progress.
Because of these problems, the patient was booked into the weekly amputee clinic/check-up for outpatients. On this day, I got called into the clinic, because I had been requested by the patient. After a chat with the patient, doctor and the prosthetist, where I basically informed them of the what had been happening over the past few weeks, the problems that we were having and what I thought was going on, a new plan was decided upon. Originally, the patient was going to get a whole new leg, but from the information that I provided, which the patient either didn’t tell or simply forgot, the prosthetist ended up just adding some extra padding to the back of the prosthesis. And judging of the vastly improved performance the following day in the gym, it worked! WOOP!
So, yeh, that was pretty rewarding for me! But to sum things up, I learnt some of the benefits of working closely with a patient, and especially those associated with a rehabilitation setting, where, by essentially being the sole therapist with the patient, I had the knowledge on what progress was/wasn’t being made. Obviously it’s not always advisable to have just the one therapist working on a case, for example it’s good to have opinions and suggestions from multiple directions, but by having someone there for most, if not all the time, they will be in a good position to decide what the next step should be, in order to maximise recovery.
All is good! Only 1 week to go!!!
Ozzman out!
Friday, November 7, 2008
Week 4 : November 7, 2008
Yo! Just a little recap of an event from yesterday.
I had to present to a group of 7/8 people a SOAPIER on one of the amputee inpatients. I had also previously been told however, that it was to be like a patient handover, which was causing me tremendous confusion, especially during research, planning and finally writing the document, because I came to the conclusion that I would do the 2 different tasks in slightly different ways. But not to worry!
Anyway, I stayed up way into the early hours of the morning to get my presentation ready and even then didn’t really feel confident with what I had to present. I ended up opting for a traditional SOAPIER style format, which was also the source of much anxiety. I had to present at 8.15, so no prep time before it! But I did quickly check with my supervisor on her thoughts about how I should present, she told me that I should just do it the way that I had written it up.
So I was doing the presentation, nervously, but my supervisor kept on interrupting and elaborating on points, which was alright, but did put added pressure on my time constraints. So I eventually finished and immediately informed my listeners that I had been quite nervous and unsure about a few things and asked what they thought of the way that I did end up doing it. They all said that because it was such an involved case, that it would have been very hard to do it in a traditional handover format, but that I handled and presented it very well. This was good!
I actually felt really crook for about an hour after I finished because I ended up getting so nervous and in such a state that the butterflies in my stomach exploded. It was pretty stupid to get so worked up, but oh well! Glad I got it out of the way!
Weekend it up people!
Ozzman out!
Yo! Just a little recap of an event from yesterday.
I had to present to a group of 7/8 people a SOAPIER on one of the amputee inpatients. I had also previously been told however, that it was to be like a patient handover, which was causing me tremendous confusion, especially during research, planning and finally writing the document, because I came to the conclusion that I would do the 2 different tasks in slightly different ways. But not to worry!
Anyway, I stayed up way into the early hours of the morning to get my presentation ready and even then didn’t really feel confident with what I had to present. I ended up opting for a traditional SOAPIER style format, which was also the source of much anxiety. I had to present at 8.15, so no prep time before it! But I did quickly check with my supervisor on her thoughts about how I should present, she told me that I should just do it the way that I had written it up.
So I was doing the presentation, nervously, but my supervisor kept on interrupting and elaborating on points, which was alright, but did put added pressure on my time constraints. So I eventually finished and immediately informed my listeners that I had been quite nervous and unsure about a few things and asked what they thought of the way that I did end up doing it. They all said that because it was such an involved case, that it would have been very hard to do it in a traditional handover format, but that I handled and presented it very well. This was good!
I actually felt really crook for about an hour after I finished because I ended up getting so nervous and in such a state that the butterflies in my stomach exploded. It was pretty stupid to get so worked up, but oh well! Glad I got it out of the way!
Weekend it up people!
Ozzman out!
Monday, November 3, 2008
Week 4: November 3, 2008
This morning I was in the hydro pool, waiting for a patient with 2 below knee amputations and some upper limb amputations aswell. I was waiting because this patient had only just started coming to the pool and needed full assistance whilst in the water. While I was waiting, the senior physio in the pool at the time suggested that I perform another patient’s program with them while I was waiting. I agreed, thinking it would be a bit of fun!
The patient had a knee disarticulation in one leg and some other complicating issues in the remaining leg and both upper limbs. The amputation was through her dominant leg, so I also assumed this position and we were off.
We performed large scale hops for 8 laps of the 20m pool, doggy paddle laps, noodle assisted breaststroke laps, sit-to-stand then balance in decreasing water depths from 60-30/40cm ALL WITH ONE LEG!!! We also did some stretching and breathing exercises. I was blown out of the water (yes, pun intended…) at how hard these exercises were, how well the patient performed them and how poorly I performed them, not to mention how completely knackered I was at the end!
This was not only a fantastic experience for me, which helped me gain a small insight into the lives of the people that I am treating, but it was also great for the patient, who was able to see that she outperformed a fairly fit, healthy (and goodlooking!), 18 year old – a massive confidence booster I’m sure!
What I gained from this, aside from a bit of fun, was some knowledge that it’s probably a good idea for physios to experience what they are prescribing if it is possible, within reason. Also that life without one of your limbs would be pretty tough, especially if there were other disabling conditions present.
Good day, very glad it’s a new week and I can put the last one behind me.
Ozzman out!
This morning I was in the hydro pool, waiting for a patient with 2 below knee amputations and some upper limb amputations aswell. I was waiting because this patient had only just started coming to the pool and needed full assistance whilst in the water. While I was waiting, the senior physio in the pool at the time suggested that I perform another patient’s program with them while I was waiting. I agreed, thinking it would be a bit of fun!
The patient had a knee disarticulation in one leg and some other complicating issues in the remaining leg and both upper limbs. The amputation was through her dominant leg, so I also assumed this position and we were off.
We performed large scale hops for 8 laps of the 20m pool, doggy paddle laps, noodle assisted breaststroke laps, sit-to-stand then balance in decreasing water depths from 60-30/40cm ALL WITH ONE LEG!!! We also did some stretching and breathing exercises. I was blown out of the water (yes, pun intended…) at how hard these exercises were, how well the patient performed them and how poorly I performed them, not to mention how completely knackered I was at the end!
This was not only a fantastic experience for me, which helped me gain a small insight into the lives of the people that I am treating, but it was also great for the patient, who was able to see that she outperformed a fairly fit, healthy (and goodlooking!), 18 year old – a massive confidence booster I’m sure!
What I gained from this, aside from a bit of fun, was some knowledge that it’s probably a good idea for physios to experience what they are prescribing if it is possible, within reason. Also that life without one of your limbs would be pretty tough, especially if there were other disabling conditions present.
Good day, very glad it’s a new week and I can put the last one behind me.
Ozzman out!
Subscribe to:
Posts (Atom)